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56 Cards in this Set
- Front
- Back
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Appropriate use of a lab test
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-Basic Screening
-Establishing Dx -D/Dx -Evaluating dz serverity -Monitor course of illness and response to Tx. -Management of a disorder -Ordering tests related to specific signs or Sx's. |
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Inappropriate uses of lab tests (2)
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-Pt ask for it
-The more info the better |
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Types of anaylsis commonly done on pt specimens
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blood
sputum urine feces exudates cerebral spinal fluid synovial fluid (joint) tissues |
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Lab value that reflects a possible emergency and which should be reported immediately to the pts clinician
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critical value (panic value)
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Test correctly identifies those persons who DO NOT have a given disease
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Specificity
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The ability of a test to detect patient with a given dz
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Sensitivity
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Test used syphilis
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RPR-inexpensive, if positive
FTA-ABS- confirm Dx-sensitive |
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Yellow tube
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blood cultures
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red or gold
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serum samples such as chemistry
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light blue
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plasma coagulation studies
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Tan/brown
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lead levels
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Lavender
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hematology and CBC
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royal blue
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Toxicology
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Gray
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Glucose levels, glucose tolerance test, and alcohol levels
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Black
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Westergren sedimentation rate
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Green
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arterial blood gases, special tests such as ammonia levels, hormones and electrolytes
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Timed specimens
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24-hour urine specimen-pt must collect all the urine produced in 24 hrs.
2 hr post prandial blood sugar(PPBS)- when fasting blood sugar (FBS) is borderline and suspect diabetes |
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Timed specimen:Glucose Tolerance test(GTT)
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3 to 5 hr duration
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SHOT GUN APPROACH
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you don't know what the heck you're doing
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Mrs. Sanchez is a 60 yr-old pt who presents to you for an yearly physical exam. She has not had any medical care in over 10 years. What type of diagnostic test might you order?
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CBC
CMP PAP EKG CHEST X-RAY MAMMOGRAM URINALYSIS |
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Mr. Gotsom comes to your clinic with a painless ulcerative lesion on his gential area. What do you suspect? What do you tell Mr. Gotsome?
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Syphilis
Treat pt and FTA-ABS test to confirm-sensitive. |
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Club Drug
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Ketamine is known as a "club drug" that is used unknowingly by the victim, who is later sexually assaulted.
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Stool occult blood, fecal occult blood testing
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yearly screeing after 50 years of age.
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Dx test:Serum potassium
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Yearly in pts taking diuretic agents or potassium supplements, in cases of some cardiac arrhythmias
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Liver enyme levels
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Monitor pt taking hepatotoxic drugs; establish baseline values
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Serum amylase
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in the presence of abdominal pain, suspect pancreatitis
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Thyroid-stimulating hormone(TSH) test
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suspicion of hypothyroidism, hyperthyroidism, or thyroid dysfunction in pts >= 50 yrs of age
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chlamydia and gonorrhea
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In sexually active persons w/ multiple partners; monitor for pelvic inflammatory dz.
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Hematocrit and hemoglobin
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Baseline study; abnormal bleeding; detection of anemia(use CBC results if they are recent)
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Cervical papanicolaou test (PAP)
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Yearly in all women >= 18 yrs of age
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urine culture
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pyuria
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TB skin test
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easiest test to use for TB screening for individuals <35 yrs of age or those w/ negative TB skin tests, for persons in resident homes
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TB blood test QuantiFERON Gold TB
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Blood test to assess TB exposure in risk population
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Fasting blood glucose (FBG)
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Every 3 yrs starting at 45 yrs of age; monitor diabetes control
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Urinalysis (UA)
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Signs or history of recurrent urinary tract dz; pregnant women; men w/ prostatic hypertrophy
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Prothrombin time (PT) (INR)
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monitoring anticoagulant Tx
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Prostate-specific antigen(PSA) and digital rectal examination
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screen men>= 50 yrs of age for prostate cancer yearly.
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Chest X-ray
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Monitor for lung lesions and infiltrates; congestive heart failure; anatomic deformities, after trauma, before surgery, follow -up for positive TB skin test and montier Tx
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Mammogram
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Screen by 40 yrs of age in women, then every 12-18 months between 40-49. annually >=50 yrs of age; follow up for history and Tx of breast cancer; routine screeing when strong family Hx of breast carcinoma
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Colon x-rays, flexible sigmoidoscopy after 5years, and colonscopy after 10 years
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screen adults for colon cancer beginning at age 45. follow for presence of hemoglobin - guaiac-positive stools, polyps, diverticulosis
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computed tomography(CT) scans
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Before & after Tx for certain cancers, injuries, illness
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DNA testing of hair, blood, skin tissue, or semen samples
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gather postmortem evidence, in certain criminal cases, establish identity and parentage. assist in establishing or ruling out familia inheritable dzs
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average person circulates how many liters of blood
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5L (3L plasma, 2L cells) 1/3 of body weight
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What diagnostic test is most frequently ordered?
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CBC
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What does CBC determine(5)
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number, variety,percentage, concentrations, quality of blood
cells |
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complete blood count (7)
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WBC
Differential WBC RBC Hematocrit Hemoglobin RBC indices Platelet count |
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RBC
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RBC carry O2 from lungs to blood tissues and CO2 from tissues to lungs
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WBC: TWO MAIN GROUPS
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granulocytes and agranulocytes
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WBC: Granulocytes consist of
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Neutrophils
basophils eosinophils |
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Granulocytes are also called
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polymorphonuclear lecukocytes beacuse they contain multilobed nucleus (polys or PMNs)
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WBC:Nongranulocytes
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Lymphocytes
Monocytes no granules and nonlobar nuclei |
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life span of leukocytes
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13-20 days, destroyed by lymphatic system
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Leukocytosis (value)
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WBC above 11,000mm3
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Causes of Leukocytosis
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Leukemia
Trauma or tissue injury Malignant neoplams Toxins,uremia,coma, eclampsia Acute hemolysis Acute hemorrage Steroid therapy |
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Leukopenia(value)
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WBC less than 4000
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Causes of Leukopenia
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Viral Infections
overwhelming bacterial infection bone marrow depression |
